Home exercise, branched-chain amino acids, and probiotics improve frailty in cirrhosis: A randomized clinical trial.

Autor:	Román E; University Nursing School EUI-Sant Pau, Barcelona, Spain.; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain., Kaür N; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Sánchez E; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.; Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain., Poca M; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain., Padrós J; Department of Physical Medicine and Rehabilitation, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Nadal MJ; Department of Physical Medicine and Rehabilitation, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Cuyàs B; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Alvarado E; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain., Vidal S; Universitat Autònoma de Barcelona, Barcelona, Spain.; Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain., Ortiz MÀ; Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain., Hernández E; University Nursing School EUI-Sant Pau, Barcelona, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain., Santesmases R; University Nursing School EUI-Sant Pau, Barcelona, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain., Urgell E; Department of Biochemistry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Juanes E; Department of Pharmacy at Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Ferrero-Gregori A; Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain., Escorsell À; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Guarner C; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain., Soriano G; Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; Universitat Autònoma de Barcelona, Barcelona, Spain.; CIBERehd, Instituto de Salud Carlos III, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Hepatology communications [Hepatol Commun] 2024 May 03; Vol. 8 (5). Date of Electronic Publication: 2024 May 03 (Print Publication: 2024).
DOI:	10.1097/HC9.0000000000000443
Abstrakt:	Background: Frailty is a predictive factor of hospitalization, falls, and mortality in patients with cirrhosis, regardless of the degree of liver failure. The aim was to analyze whether a multifactorial intervention consisting of home-based exercise, branched-chain amino acids, and a multistrain probiotic can improve frailty in these patients. Methods: Outpatients with cirrhosis were classified according to the Liver Frailty Index (LFI). Prefrail and frail patients were randomized into 2 groups. The intervention group was assigned to a multifactorial intervention consisting of exercise at home, branched-chain amino acid supplements, and a multistrain probiotic for 12 months. The control group received standard care. All patients were prospectively followed up every 3 months for 1 year to determine LFI, incidence of falls, emergency room visits, hospitalizations, and mortality. Results: Thirty-two patients were included: 17 patients were assigned to the intervention group and 15 to the control group. In the intervention group, the baseline LFI decreased at 3, 6, 9, and 12 months (p = 0.019 for overall change with respect to the control group). The change in LFI (ΔLFI) at 12 months was -0.71 ± 0.24 in the intervention group and -0.09 ± 0.32 in the control group (p<0.001). During follow-up, patients in the intervention group had a lower 1-year probability of falls (6% vs. 47%, p = 0.03) and emergency room visits (10% vs. 44%, p = 0.04) than patients in the control group. Conclusions: A long-term multifactorial intervention that included exercise at home, branched-chain amino acids, and a multistrain probiotic improved frailty in outpatients with cirrhosis and was associated with a decrease in the incidence of clinical events such as falls and emergency room visits. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.)
Databáze:	MEDLINE
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